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Published on: July 16, 2014
Impulse control disorders in Parkinson's disease: recent advances
Valerie Voon1, Arpan R Mehta, Mark Hallett
1Behavioural and Clinical Neurosciences Institute, University of Cambridge, Cambridge, UK. vv247@cam.ac.uk
Current Opinion in Neurology
|July 5, 2011
Summary
Impulse control disorders (ICDs) affect 13.6% of Parkinson's disease patients, impacting daily functioning. Understanding these dopamine-related mechanisms is key to optimizing treatment and prevention strategies.
Area of Science:
- Neurology
- Neuroscience
- Psychiatry
Background:
- Impulse control disorders (ICDs) are increasingly recognized complications in Parkinson's disease (PD).
- These disorders significantly impair patient functioning and quality of life.
Purpose of the Study:
- To review recent advances in the epidemiology and pathophysiology of ICDs in Parkinson's disease.
- To synthesize current understanding of the mechanisms underlying ICDs in PD.
Main Methods:
- Review of large cross-sectional and case-control multicentre studies.
- Analysis of observational, neurophysiological, and neuroimaging studies.
- Synthesis of data on dopamine agonist effects and patient cognitive profiles.
Main Results:
- ICDs affect 13.6% of PD patients, associated with depression, anxiety, and novelty seeking.
- Behavioral subtypes suggest distinct pathophysiological underpinnings.
- Evidence points to mechanistic overlap between ICDs and dyskinesias, involving dopamine pathways.
- Dopamine agonists may enhance reward learning and impulsive choice, with altered risk preference and working memory observed.
- Neuroimaging reveals enhanced ventral striatal dopamine release and potential orbitofrontal inhibition.
Conclusions:
- Recent studies provide a growing understanding of ICD mechanisms in Parkinson's disease.
- This knowledge can inform the development of preventative measures and optimized therapeutic strategies for ICDs.
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